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General NPI Number Information
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NPI Number | 1871317032
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Entity Type | Organization
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Legal Business Name | CHATEAU #1
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 1860 S ORANGE GROVE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90019-5049
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Country | US
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Telephone | 323-297-3001
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Fax |
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Provider Business Mailing Address
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Address Line | 11751 MISSISSIPPI AVENUE SUITE 100
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City | LOS ANGELES
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State | CA
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Zip | 90025-6130
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Country | US
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Telephone | 310-801-0027
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | FAZEELA SHAIKH
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Credential |
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Telephone | 310-810-0027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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